摘要
目的了解院感防控处方制度对中央血管导管置管患者疾病负担的影响,优化其管理模式。方法采用整群抽样的方法,选取2022年1月1日至2023年6月30日在成都中医药大学附属第五人民医院住院的599例中央血管导管置管患者为研究对象,根据患者所在病区不同分为试验组(实施院感防控处方制度管理,n=256)与对照组(实施传统模式管理,n=343)。采用倾向评分匹配两组患者的基线资料,使用自制问卷收集两组患者人口学特征、疾病类型、急性生理与慢性健康评分Ⅱ评分、序贯器官衰竭评估评分、院内感染等;同时对两组患者的医务人员按比例抽样观察手卫生时机400次,分析医务人员手卫生执行情况。结果试验组的医疗总费用、实验室诊断费、抗菌药物费、带管时间、抗生素使用时间及院内感染发生率均低于对照组(P<0.05);对照组医务人员手卫生执行率白天高于夜晚(P<0.05),而试验组医务人员手卫生执行率白天与夜晚比较差异无统计学意义(P>0.05);试验组隔离医嘱10 min执行率、多耐防控集束化措施全部落实率高于对照组(P<0.05);试验组院内感染发生率低于对照组(P<0.05)。结论院感防控处方制度实施可减少中央血管导管患者治疗成本,提高医务人员院感防控措施落实成效,减少患者院内感染的发生。
Objective To understand the effect of prescription system for nosocomial infection prevention and control on disease burden in patients with central venous catheter,so as to optimize the management mode.Methods A total of 599 patients with central venous catheter in Chengdu Fifth People's Hospital Affiliated to Chengdu University of Traditional Chinese Medicine from January 1,2022 to June 30,2023 were selected by cluster sampling method as the study objects.They were allocated to either an experimental group(managed by prescription system for nosocomial infection prevention and control,n=256)or a control group(managed by traditional mode,n=343)according to different wards they were in.Propensity score was used to match the basic data of the two groups of patients.Self-designed questionnaires were used to collect demographic characteristics,disease types,Acute Physiology and Chronic Health Evaluation(APACHE)Ⅱscores,Sepsis-Related Organ Failure(SOFA)scores,and incidence of nosocomial infection in both groups.The medical staff of both groups were sampled proportionally for a total of 400 times to observe and analyze their implementation of the World Health Organization(WHO)"My 5 Moments for Hand Hygiene".Results The total medical cost,laboratory diagnosis cost,antibacterial drug cost,catheter indwelling time,duration of antibiotic use and the incidence of nosocomial infection in the experimental group were lower than those in the control group(P<0.05).The implementation rate of hand hygiene of medical staff in the control group during the day was higher than that at night(P<0.05),while that in the experimental group exhibited no significant difference between day and night(P>0.05).The 10 min implementation rate of quarantine orders and the full implementation rate of comprehensive measures against multi-drug resistant bacteria in the experimental group were higher than those in the control group(P<0.05).The incidence of nosocomial infection in the experimental group was lower than that in the control group(P<0.05)
作者
周贵
晏殊
王吉丽
罗德军
罗江磋
刘佳
Zhou Gui;Yan Shu;Wang Jili;Luo Dejun;Luo Jiangcuo;Liu Jia(Department of Nosocomial Infection Management,Chengdu Fifth People's Hospital Affiliated to Chengdu University of Traditional Chinese Medicine,Chengdu 611130,China;Department of Orthopaedics,The People's Hospital of Jianyang City,Chengdu 641400,China;Department of Internal Medicine,Songpan People's Hospital,Aba Prefecture,Aba 623300,China)
出处
《成都医学院学报》
CAS
2024年第1期125-129,共5页
Journal of Chengdu Medical College
基金
四川省科技厅软科学资助项目(No:21RX0084)
四川省医院协会医务管理分会2022年度专项资助项目(No:SCYW005)
成都市卫生健康委员会医学科研资助项目(No:2022402)。
关键词
院感防控
处方
中央血管导管
疾病负担
Nosocomial infection prevention and control
Prescription
Central venous catheter
Disease burden
